Having Minimally Invasive Spine Surgery (MISS)
Minimally invasive spine surgery (MISS) is a type of surgery on the bones of your backbone (spine). This type of surgery uses smaller cuts (incisions) than standard surgery. This often causes less harm to nearby muscles and other tissues. It can lead to less pain and faster recovery after surgery. Surgeons can use MISS for some types of spine surgery. These include lumbar discectomy, laminectomy, and spinal fusion.
What to tell your healthcare provider
Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements. And tell your healthcare provider if you:
Have had any recent changes in your health, such as an infection or fever
Are sensitive or allergic to any medicines, latex, tape, or anesthesia (local and general)
Are pregnant or think you may be pregnant
Tests before your surgery
Before your surgery, you may need imaging tests. These may include ultrasound, X-rays, or MRI.
Getting ready for your surgery
Talk with your healthcare provider about how to get ready for your surgery. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your surgery. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.
Also, make sure to:
Ask a family member or friend to take you home from the hospital
Follow any directions you are given for not eating or drinking before surgery
Follow all other instructions from your healthcare provider
You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully. Ask questions if something is not clear.
On the day of your surgery
MISS is done by an orthopedic surgeon or neurosurgeon and a trained medical team. The details of MISS vary depending on what part of the spine is being treated, and other factors. Your healthcare provider can help explain what to expect for your surgery. The following is an example of how MISS is done:
You may have a type of anesthesia that numbs part of your body. You’ll also be given sedation. This will make you relaxed but awake during surgery. Or you may be given general anesthesia. This prevents pain and causes you to sleep through the surgery.
A healthcare provider will carefully watch your vital signs, like your heart rate and blood pressure, during the surgery.
You may be given antibiotics before and after the surgery. This is to help prevent infection.
During the procedure, the surgeon will use a special type of X-ray to view the surgery.
The surgeon will make a small incision on your back in the area that needs to be treated. He or she will put a tubular retractor into this incision. This will let the surgeon reach the part of the spine to be treated.
The surgeon will then pass small tools through this retractor. This may include a tiny camera and a light.
The surgeon will then make the needed repairs to the spine.
When the repairs are done, the surgeon will remove the tools and retractor. He or she will close the incision or incisions with sutures, glue, or staples. A small bandage is put on the wound.
After your surgery
Some types of MISS can be done as an outpatient procedure. This means you can go home the same day. You will need to stay for a couple of hours after the procedure so your healthcare provider can watch for problems. Or you may need to stay one or more nights in the hospital. When you’re ready to go home, you’ll need to have someone drive you.
Recovering at home
You will have some pain after the surgery. This can be relieved with pain medicines. Ask your healthcare provider if there are any over-the-counter pain medicines you should not take. Often the pain will go away fairly quickly.
Your healthcare provider will give you instructions about how you can use your back after surgery. You may need to limit lifting or bending. You may need to wear a back brace for a time after the procedure. And you may need physical therapy after the surgery. This is to help strengthen muscles around the spine and help you recover. Your recovery time will vary depending on the type of surgery you had and your general health. You may be able to go back to normal activities in a few weeks.
Make sure to follow all of your healthcare provider's instructions about treatment and follow-up appointments. This will help make sure the surgery works well for you.
When to call your healthcare provider
Call your healthcare provider right away if you have any of these:
Fever of 100.4°F (38.0°C) or higher
A lot of fluid leaking from the incision site
Symptoms that don’t get better
Weakness, trouble urinating, or loss of sensation
Pain that is getting worse
February 22, 2018
Chou R. Subacute and chronic back pain: surgical treatment. UpToDate.
Fetterman, Anne, RN, BSN,Jasmin, Luc, MD